Patient/caregiver was educated on contraindications for using Remeron as follows:
- Remeron is extensively metabolized in the liver to some active metabolites that are excreted in the feces and urine. If liver function is deficient, the metabolism of Remeron can be compromised. This can lead to increased blood levels of the medication for longer periods of time, resulting in increased risk for side-effects and consequent toxicity. So, Remeron must be used with caution in individuals with history of compromised liver function, with periodical monitoring for liver functions and development of any toxic symptoms.
- All the metabolites of Remeron are mainly excreted in the feces and urine. Individuals with renal disease cannot excrete these active metabolites normally, which allows them to stay in blood circulation for longer time, resulting in toxicity and consequent side-effects. So, Remeron must be used with caution in individuals with compromised renal function, with periodical monitoring for renal functions and development of any toxic symptoms.
